Obesity in Southwark

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Obesity in Southwark

• Dr Alan Maryon Davis
• Director of Public Health
• for Southwark

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The obesity time-bomb

• In children, over the past decade
• Obesity has doubled in 6 year-olds (to 8.5)
• And trebled in 15 year-olds (to 15)
• Middle-aged complications (eg Type 2 diabetes,
  and back trouble) are now appearing in children

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The obesity epidemic

• Over the past 20 years in the UK
• The number of overweight people has risen by 60
• The number of obese people has trebled
• Obesity and its consequences are costing about 5
  of the total NHS expenditure
• The cost to the economy is estimated at around 7
  billion annually

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Health consequences

• Type 2 diabetes
• Raised cholesterol
• Hypertension
• CHD
• Gallstones
• Cancers

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Health consequences

• Subfertility (mainly women)
• Sleep apnoea (mainly men)
• Back pain
• Joint symptoms
• Surgical risk
• Psychological distress

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PSA Target

• Shared by DfES,
• DCMS DoH
• To halt the
• year-on-year rise
• in obesity
• in the under 11s
• by the year 2010

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Why is it happening?
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Lifestyle influences
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Children young peoples eating and drinking
habits

• More meals eaten outside the home
• More snacks
• More grazing - fewer set meals
• More fast foods less cooking
• More soft drinks
• More alcohol

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Children young peoples exercise habits

• More time watching TV, videogames etc
• Less activity and sports at school
• Less active play at home
• Less active travel (walking and cycling)
• Culture of exercise as not cool, particularly
  among teenage girls

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Southwark Childrens Heights Weights Survey

• All 72 schools, 4753 pupils
• 80 participation rate
• Ethnicity profile
• 33 black
• 21 white
• 6.5 mixed
• 4.5 Asian or Chinese
• 3 other
• 31 not recorded

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Headline results

• 12 overweight
• 18 obese
• 30 overweight including obese
• Year R - 13.6 obese
• Year 6 - 23.5 obese

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By school
Greater problem in the middle and north west
areas correlates with deprivation and ethnicity
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Survey of over 1500 pupils aged 8-11 in
Southwark 2004
Source SHEU 2004
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So, what can we do about it?
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The ThreeEssential Es for Behaviour Change
Environment
Empowerment
Encouragement
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Big questions

• Who to target?
• In what settings?
• How to intervene?
• How to incentivise?
• And very importantly.
• How to measure progress

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Obesity The prevention, identification,
assessment and management of overweight and
obesity in adults and children
December 2006
NICE clinical guideline 43
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Assessment and managementadults
Determine degree of overweight or obesity
Consider referral to specialist care
Assess lifestyle, comorbidities and willingness
to change
Specialist assessment and management surgery
and follow up
Management lifestyle changes drug treatment
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National Heart ForumFaculty of Public
HealthToolkit for developing local strategies
to tackle overweight obesity in children and
adults
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Obesity target unlikely to be met
Thursday, 25 January 2007

• The government has been too slow to react to
  rising levels of childhood obesity, an MPs'
  report has warned.
• Despite a target to halt the rise of obesity
  among under-11s by 2010, the Commons Public
  Accounts Committee said little concrete action
  had been taken.
• There is no clear leadership among departments
  who have been "confused" and "dithering", said
  the MPs.

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Further info, downloads, etc

• www.nice.org.uk
• www.heartforum.org.uk